Provider Demographics
NPI:1548975659
Name:GEORGIA BARIATRICS P.C.
Entity type:Organization
Organization Name:GEORGIA BARIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-357-0526
Mailing Address - Street 1:4200 NORTHSIDE PKWY NW
Mailing Address - Street 2:BUILDING 8, SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:678-357-0526
Mailing Address - Fax:877-787-7051
Practice Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 8
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3007
Practice Address - Country:US
Practice Address - Phone:678-357-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty